Drinking Water Supplemented with Acidifiers Improves the Growth Performance of Weaned Pigs and Potentially Regulates Antioxidant Capacity, Immunity, and Gastrointestinal Microbiota Diversity.

This study evaluated the potential effects of adding acidifiers to the drinking water on the growth performance, complete blood count, antioxidant indicators, and diversity of gastrointestinal microbiota for weaned pigs. A total of 400 weaned pigs were randomly divided into four treatments. Pigs were fed the same basal diet and given either water (no acidifier was added, control) or water plus blends of different formulas of acidifiers (acidifier A1, A2, or A3) for 35 days. On d 18 and 35 of the experimental period, 64 pigs (four pigs per pen) were randomly selected to collect blood for a CBC test (n = 128) and an antioxidant indicators test (n = 128); 24 pigs (six pigs per group) were randomly selected to collect fresh feces (n = 48) from the rectum for 16S rRNA gene sequencing. Compared to the control, supplementing the drinking water with acidifiers improved the growth performance and survival rate of weaned pigs. Acidifier groups also increased serum catalase (CAT) and total antioxidant capacity (T-AOC) activities, while also displaying a decreased malondialdehyde (MDA) concentration compared to the control. The relative abundance of Firmicutes in the acidifier A1 group was greater than that in the control group (p < 0.05) on d 35; the relative abundance of Lactobacillus in the acidifier A1 group was greater than that in the control group (p < 0.05) on d 18 and 35. The microbial species Subdoligranulum or Ruminococcaceae_UCG-005 had significantly positive correlations with ADG and ADFI or with serum antioxidant indicators, respectively. These findings suggest that supplementing the drinking water with an acidifier has a potential as an antioxidant, which was reflected in the improvement of growth performance, immunity, antioxidant capacity, and intestinal flora.

Dexmedetomidine improves early postoperative cognitive dysfunction in aged mice.

Postoperative cognitive dysfunction (POCD) is a frequent complication following major surgery in the elderly. However, the exact pathogenic mechanisms are still unknown. Dexmedetomidine, a selective alpha 2 adrenal receptor agonist, was revealed anesthesia and brain protective role. The present study aimed to examine whether dexmedetomdine protects against POCD induced by major surgical trauma under general anesthesia in aged mice. In the present study, cognitive function was assessed by Y-maze. Proinflammatory cytokines interleukin-1ß (IL-1ß) and tumor necrosis factor (TNF-α), apoptosis-related factor caspase-3 and Bax were detected by real-time PCR, Western blot or immunohistochemistry. The results showed that anesthesia alone caused weak cognitive dysfunction on the first day after general anesthesia. Cognitive function in mice with splenectomy under general anesthesia was significantly exacerbated at the first and third days after surgery, and was significantly improved by dexmedetomidine administration. Splenectomy increased the expression of IL-1ß, TNF-α, Bax and caspase-3 in hippocampus. These changes were significantly inversed by dexmedetomidine. These results suggest that hippocampal inflammatory response and neuronal apoptosis may contribute to POCD, and selective alpha 2 adrenal receptor excitation play a protective role.

[Impact of pulmonary hypertension on early hemodynamics after orthotopic heart transplantation].

OBJECTIVE: To determine the influence of normal pulmonary artery pressure, and mild to moderate and severe pulmonary hypertension on the early hemodynamics, morbidity, and mortality after orthotopic heart transplantations. METHODS: Sixty-seven heart disease patients, 54 males and 13 females, aged (46.4 +/- 14.6), including ischemic heart diseases (n = 16), myocardiopathy (n = 43), and other heart diseases (n = 8), underwent orthotopic heart transplantation. Before and after transplantation routine right heart catheterization was conducted. According to the preoperative pulmonary arterial pressure the patients were divided into 3 groups: Group I (n = 15) without pulmonary hypertension (PH) with the pulmonary vascular resistance (PVR) < or = 2.5 Wood's units; Group II (n = 42) with mild to moderate PH with the PVR between 2.5 and 5.0 Wood's units; and Group III (n = 10) with severe PH with the PVR > or = 5.0 Wood's units. Heart rate (HR), mean artery pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (MPAP), pulmonary artery wedge pressure (PAWP), PVR, cardiac output index (CI), and mixed venous oxygen saturation (S(V)O(2)) were measured preoperatively, immediately and 12, 24, and 48 hours postoperatively. 1, 3, and 7 days, and 1 and 3 months post-operatively echocardiography was conducted to measure the left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (EF), mitral valvular regurgitation (MVR), and tricuspid valvular regurgitation (TVR). Postoperative complications and mortality were recorded. RESULTS: The 30-day mortality was zero in all 3 groups. The cardiovascular support used for weaning CPB and postoperative period included dopamine, ephedrine and isoproterenol. In addition, nitroglycerin, NO and iloprost were administered for pulmonary artery vasodilation if the pulmonary artery pressure was higher than 45 mm Hg. The EF value of Group III was significantly lower compared with group (P < 0.05). Before the heart transplantation, 52 patients (86%) had mild to severe PH, of which 10 patients (27%) had severe PH. The patients of Group III had longer CPB time and tracheal intubation time in comparison with the patients of Group I (P < 0.05). Postoperatively 6 patients, 1 in Group I, 2 in Group II, and 3 in Group III, had acute right ventricular failure and 3 patients, 1 in Group II and 2 in Group III, had renal failure. Basiliximab, cyclosporine A, mycophenolate mofetil, and methylprednisolone were administered for immunosuppressive treatment perioperatively. CONCLUSION: The patients with severe PH pre-operatively have significantly lower pulmonary resistance and pressure, and have more complications, such as acute right heart failure, post-operatively. Active treatment with cardiac stimulant and diuretics is helpful. Smooth anesthetic induction and maintenance, peri-operative stable hemodynamic managements, especially the protection of right ventricle function for the first 2 weeks after the transplantation, myocardial protection of donor heart, and immunosuppressive regimen all play important roles for successive heart transplantation.

Passive graft perfusion in off-pump coronary artery bypass grafting.

BACKGROUND: Myocardial protection during off-pump coronary artery bypass grafting (OPCABG) is a multifactorial problem in which maintaining stable systemic hemodynamics is very important. In this study passive graft perfusion (PGP) was applied to investigate the effect during and after OPCABG as evaluated by cardiac troponin I (CTnI) and hemodynamic indexes. METHODS: Thirty first-time patients underwent OPCABG under one surgeon. They were randomly divided into two groups: The passive graft perfusion group (PGP, n = 15) received distal coronary perfusion during the anastomosis and immediate graft perfusion after the distal anastomosis. The control group, no graft perfusion group, (NGP, n = 15) received no graft perfusion after the distal anastomosis. The results of the two protocols were evaluated by concentration of CTnI and hemodynamic indexes before induction and after operation. RESULTS: There were no statistically significant differences between these two groups in their perioperation parameters. The level of CTnI increased postoperatively, reached its peak at 6 hours (P < 0.05) and recovered by the 6 days postoperative. Compared with the control group the concentration of CTnI in the PGP group was significantly lower at 6 and 24 hours (P < 0.01). Compared with the NGP group, cardiac index (CI) in the PGP group was higher at 12 and 24 hours after operation (P < 0.05). The period of mechanical ventilation was significantly shorter in the PGP group than in the NGP group (P < 0.05). CONCLUSION: PGP can increase the flow to the myocardium and shorten the heart ischemia time, thus maintain stable systemic hemodynamics, supply a satisfactory CI after surgery and improve surgery outcome.

[The safety and efficacy of basiliximab as induction agent in preventing early acute rejection in Chinese cardiac transplantation receipts].

OBJECTIVE: To investigate the safety and efficacy of basiliximab as induction agent in preventing early acute rejection post heart transplantation. METHODS: Basiliximab (20 mg, iv) was administered one hour before and 4 days post operation to patients (n = 47) underwent heart transplantation between June 2004 and Feb 2005 in our department. Intravenous methylprednisolone (500 mg at operation beginning and repeated immediately post operation, followed by 125 mg every 8 hours for the first day). Prednisone was then initiated at 1 mg.kg(-1).d(-1) tapered 10 mg every 3 days to 10 mg/d. Mycophenolate mofetil (MMF, 0.5 - 1.0 g twice daily) was also administered post intubation, oral Cyclosporine A (CsA, 3 to 6 mg.kg(-1).d(-1)) was prescribed after transplantation if serum creatinine was < 150 micromol/L. The dose of CsA was individually adjusted to achieve a target serum concentration of 180 - 300 ng/ml. Endomyocardial biopsies were performed 3 weeks (19.7 +/- 9.6) d post heart transplantation. Biopsy specimens were graded according to the standardized criteria of the International Society for Heart and Lung Transplantation (ISHLT). Echocardiograms were routinely performed weekly within the first 3 weeks post-operation. RESULTS: All 47 consecutive patients [mean age (44.9 +/- 13.4) years, range 13 - 63 years, 38 men] survived the operation and the underlying diseases was idiopathic cardiomyopathy (42.5%), ischemic heart disease (25.5%), arrhythmogenic right ventricular cardiomyopathy (17.0%), hypertrophic cardiomyopathy (4.2%), heart tumor (4.25%), valve heart disease (2.1%), hypertensive cardiomyopathy (2.1%) and giant cell myocarditis (2.1%). There were 4 patients with pre-operation PRA > 10% and CDC was less than 5% in all patients. The grades of the acute rejection in biopsy specimens were as follow: Grade (G) 0 in 30 (63.8%), G IA in 11 (23.4%), G IB in 3 (6.3%) and GII in 3 (6.3%) patients. The average dose of MMF was (1.2 +/- 0.3) g/d. The initial time of receiving CsA was (3.4 +/- 2.1) day post operation. The average cumulative dose of CsA was (4.1 +/- 1.2) mg.kg(-1).d(-1) before endomyocardial biopsy. The average serum concentration of CsA was (237.0 +/- 76.2) ng/ml. Left ventricular ejection fraction assessed by echocardiogram was normal in all patients within the first 3 weeks. Five patients suffered from respiratory infections and recovered post antibiotic and symptomatic therapies. CONCLUSION: Basiliximab as induction agent in combination with conventional triple immunosuppressive therapy is safe and effective in preventing acute rejection in Chinese cardiac transplantation receipts.